Rapid control of a scabies outbreak at a tertiary care hospital without ward closure

Khan, Anjum; O’Grady, Sharon; Muller, Matthew P.

doi:10.1016/j.ajic.2011.05.014

Cited by 30 publications

(42 citation statements)

References 16 publications

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“…The presence of millions of mites in the crusted variant makes this disease highly contagious, often leading to outbreaks. An outbreak stemming from a single case of crusted scabies in Toronto was found to have an attack rate of 22% from the index case . A combination of barrier precautions, environmental cleaning, contact tracing, internal and external communication efforts, and mass prophylaxis of 385 individuals led to an end in the outbreak within 2 months without ward closure.…”

Section: Discussionmentioning

confidence: 99%

“…Seven patients presented with a concomitant infection, out of which three patients died. The first patient was found to have a S aureus perineal abscess and brain abscess, the second had both herpes simplex virus and polymicrobial bacteremia, and the third developed a urinary tract infection followed by intra‐abdominal sepsis secondary to gastric ulcer perforation . All surviving patients were noted to have complete, or near complete resolution of disease.…”

Section: Literature Review Of Cases Of Crusted Scabies In Renal Transmentioning

confidence: 99%

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Crusted scabies in a renal transplant recipient treated with daily ivermectin: A case report and literature review

Wang

Chin‐Yee

et al. 2019

Transplant Infectious Dis

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Crusted scabies is a rare disease variant associated with T‐cell dysregulation. Transplant patients are at risk of developing crusted scabies as a consequence of their immunosuppressive regimens. We report a case of crusted scabies presenting with recurrent septicemia in a 65‐year‐old renal transplant recipient, treated with daily ivermectin for 7 days after initial failure of weekly ivermectin dosing. A literature review of crusted scabies in transplant recipients consisting of 19 cases reports was summarized. Pruritus was common, and initial misdiagnosis was frequent. Most were treated with topical therapy, with one‐third receiving ivermectin. Three of seven cases presenting with a concomitant infection died. Crusted scabies is commonly misdiagnosed in transplant recipients owing to its rarity, varied appearance, and different skin distributions. It should be considered in the differential diagnosis of transplant recipients presenting with rash and pruritus, given its association with secondary infection and subsequent mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Literature Review Of Cases Of Crusted Scabies In Renal Transmentioning

confidence: 99%

Crusted scabies in a renal transplant recipient treated with daily ivermectin: A case report and literature review

Wang

Chin‐Yee

et al. 2019

Transplant Infectious Dis

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“…Factors facilitating the development of the disease were poor knowledge of scabies epidemiology, unfamiliarity of physician and nurses with atypical presentations, long incubation period, diagnostic delay, and incomplete monitoring (5). Similar data originated from more recent epidemics in Switzerland (23), Germany (24), Canada (25), and Italy (26). Management of scabies' outbreaks is problematic.…”

Section: Scabies and Healthcare Workersmentioning

confidence: 94%

Occupational risk of scabies among healthcare workers: problem focus and personal experience

Stefano¹

2016

PER

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Introduction: scabies is a contagious parasitic disease which can cause hospital outbreaks, with possible involvement of sanitary staff, and considerable economic and managerial implications. The Policlinico San Matteo of Pavia adopts (since 2005) a protocol for the management of index cases, based on early patient isolation, identification of close contacts, and their prophylactic treatment. We report here descriptive data on reported cases of scabies and on the effectiveness of the protocol. Materials and Methods: retrospective study (2005-2014) of the index cases. For each case, clinical data were collected, as well as information on the healthcare workers who had dealt with the patient within the 6 weeks (maximum scabies incubation period) preceding the diagnosis. Results: 30 index cases were identified: 11 females and 19 males; mean age 60 years; range: 2 months -92 years. 9 patients had been transferred from other health facilities. 11 were immunosuppressed: of these, 3 were suffering from Norwegian scabies (a highly contagious variant). Close contacts included 894 health professionals, mainly nurses, physicians and students; of these, 158 had provided care to patients with Norwegian scabies: 15 (1.7% of the entire sample) were infected. This percentage is below the rates of infection (sometimes > 30%) reported in other case series. Discussion: scabies is a major occupational hazard in hospitals, especially for nursing staff, including students in training. Immunocompromised patients are particularly dangerous, since they are more prone to developing Norwegian scabies. The operative protocol adopted by the Policlinico San Matteo is effective for risk containment.

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“…Scabies is caused by infestation of the skin with Sarcoptes scabiei , and outbreaks are not uncommon in some establishments and hospitals even in developed countries . Although external and oral preparations for scabies treatment are available, both types of preparation have disadvantages in addition to their advantages.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of ivermectin applied topically by whole‐body bathing method in healthy volunteers

Miyajima

Hirota

Tashiro

et al. 2016

The Journal of Dermatology

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As a novel administration method of ivermectin (IVM) for scabies treatment, we proposed a "whole-body bathing method (WBBM)". In this method, the patients would bathe themselves in a bathing fluid containing IVM at an effective concentration. Previously, we demonstrated that WBBM could deliver IVM to the skin but not to the plasma in rats. In the present study, to assess the clinical validity of the method an arm bathing examination (first trial) and a whole-body bathing examination (second trial) were conducted in healthy volunteers. In both the first and second trials, after bathing in fluid containing IVM, the exposure in the stratum corneum was higher compared with that after taking IVM p.o. as reported previously. IVM was not detected in plasma at any sampling point after the whole-body bathing in the second trial. Furthermore no serious adverse events were found. These results in both trials suggest that WBBM can deliver IVM to the human stratum corneum without systemic exposure or serious adverse effects in healthy volunteers, and at concentrations that would be adequate for scabies treatment.

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Rapid control of a scabies outbreak at a tertiary care hospital without ward closure

Cited by 30 publications

References 16 publications

Crusted scabies in a renal transplant recipient treated with daily ivermectin: A case report and literature review

Crusted scabies in a renal transplant recipient treated with daily ivermectin: A case report and literature review

Occupational risk of scabies among healthcare workers: problem focus and personal experience

Pharmacokinetics of ivermectin applied topically by whole‐body bathing method in healthy volunteers

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